Hi, Brian.

Recently, I have seen ads for the new immunotherapy drug, Opdiva, as being one to prolong the lives of those with advanced stage SCC in the lungs.

Since you are right on top of these things, I was wondering if you have heard if it would potentially benefit certain patients with lungs mets or OC/OPC in general.

Just curious .

Best,
Kerri

I am curious about this as well

If your lung cancer is a met from your oral/oropharyngeal cancer, the answer is yes you are a candidate. You need to have failed primary treatment with radiation and cisplatin to get into any on going trials. For the limited approval of the drug from FDA, you still need to have already had cisplatin. I watched this go through trials at the NCI oversight committee that I am on, and there are now 4 companies with variants of this idea in the market this was just the first. This got fast tracked from the FDA before the clinical trials were done because the results were so positive.

But not for everyone, and there are still many questions about the side effects and dosing levels to be answered in trials. So while immune checkpoint inhibitors (pd-1 pathway) are an amazing thing for turning your own immune system on, actually allowing it to see something that it was not recognizing as a threat before, there have been a few cases where the immune system attacked more than the tumor with a negative result to the patient.

This is an amazing breakthrough. My Xmas donation ask letter is partly written around this, this year that I will be sending out to thousands of OCF supporters in a week, as OCF was a financial funder along with the NCI and private sector in the idea. We also referred a bunch of patients into the trials. That portion of the patients that did respond have had long durable remissions. Remember that these were patients I was talking to had no hope, and the doctors had pretty much told them to go home and get their affairs in order.

People here on this board are probably the only ones who understand how this impacted me personally, as I talk to these kinds of patients every week, and it is one of the hardest parts of what I do for OCF. But today many of those patients are alive because of immune checkpoint inhibitors. It has completely changed the optimism that I can express to them, and where I can point them compared to just a year ago. The first out was from BMS, then Merck, then Astra Zeneca, and more companies are following as there are slightly different means to approach the idea.

I can see a point in the future where this will become part of the cocktail of things that are done in primary treatment. While we have epidermal grow factor monoclonal antibodies, which have been around for awhile; now we have one designed around the programed death immune checkpoint signaling pathway, and more mechanisms like this are being currently explored. The next step will be careful proteomic and genetic profiling of patients to determine which combination of these things will work for them, as we have seen with the EGFR attack, it does not work on every patient from every etiology.

Thanks for sharing all of your knowledge, Brian.

The future is looking brighter in cancer therapy.

Thanks for all that you do.

This is such great news as Brian has suggested this to me already. I am hopeful that I will soon be on one of these as my oncologist has told me it should be the next route I take. I don't want to get my hopes up too high, but the idea of possibly getting a few extra years is very encouraging.

This is indeed wonderful news.
To have Hope is a fantastic thing.
Having just read your email Brian, I want to take this opportunity to really express my appreciation for all that you do for OCF. Thankyou from the bottom of my heart.
Tammy and Kris.

So Friday afternoon had a meeting with Dr. Gillison, and she has let me know that early next year she will be the lead investigator on new trials using these drugs in primary treatment. The trials will essentially look at PDL-1 drug with radiation and cisplatin, PDL-1 with radiation and Erbitux ( in patients that have the marker for effectiveness of EGFR inhibitors), with PDL-1, radiation and no chemo. So those trials will allow these to get into the primary treatment realm likely as early as next fall if they have the same impact as they did in these failing patient trials. The future is brighter, and this is just the beginning of the types of therapies. They will also need to start genetic profiling of patients like they did for EGFR, so we can target just the patients in which this pathway or future ones is implicated in the original disease. A decade from now there will be an armamentarium of monoclonal antibody type drugs out there that will have efficacy in very specific patients that show a susceptibility to that particular one working in them.

While OCF has played a very small role in this as millions of dollars have been thrown at this idea from multiple sources, we have been players in small financial donations to research, and most importantly driving patients to the clinical trials that were so successful. We almost filled one trial by ourselves, and I am very grateful that those that we referred felt some comfort in following our recommendation, and that so many of the people that interact with OCF have come to donate what they can to not only keep OCF alive, but to allow us to contribute to things like this that we find promising. In the previous post I eluded to the Xmas ask letter that got mailed out to many people, If you would like to read it since it chronicles a little bit about how OCF came to be and what it has become you can follow this link. http://www.oralcancerfoundation.org/holiday/index.php

It's exciting to see things moving forward. Thanks, Brian!

Dear Brian,

Reading your Holiday Wish, I felt all kinds of emotions erupt within me: empowerment, inspiration, drive, joy, excitement, a sense of belonging to something greater than what I can ever do alone, belonging, tenacity, and hope...It brought tears to my eyes and passion to my voice as I read it aloud. It was nothing less than magnificent.

This news ignites new hope for patients who otherwise would be considered "terminal". And now, for patients as part of primary therapy!

I am so happy and proud that OCF is part of the future of these treatments!

I am so grateful to OCF this holiday season and every day. May your Holiday wish come true for you and for all of us.

I will be sharing this for sure!

Gratefully yours,
Kerri

For the Canadian members, this is an article and an explanatory talk from Dr. Pamela Ohashi, Senior Scientist, at the Princess Margaret Hospital on immunotherapy at the hospital.

http://thepmcf.ca/Our-Stories/Insid...most-comprehensive-immunotherapy-program